TITLE: Financial Assistance/Community Benefit Policy for Northeast Georgia Physicians Group
|
|
- Brett O’Neal’
- 6 years ago
- Views:
Transcription
1 TITLE: Financial Assistance/Community Benefit Policy for Northeast Georgia Physicians Group TYPE: NGPG PRIMARY REVIEWER: System Director, Patient Receivables FINAL APPROVER: CFO COLLABORATORS/DEPARTMENTS: [Collaborators] PURPOSE Provides guidelines to ensure consistent processing for Financial Assistance. POLICY STATEMENT It is the policy of Northeast Georgia Physicians Group (NGPG) to provide emergency care to all patients regardless of ability to pay. The group shall allocate resources to identify financial assistance cases and provide uncompensated care based upon the information submitted at the time of application for financial assistance by the patient or their representative or through the use of other criteria-based methods to determine eligibility. Financial assistance adjustments may only be granted to patients receiving non-elective care. Financial assistance adjustments may be applied to approved accounts for uninsured patients based on the patient s total gross family income and the patient s willful cooperation in applying for Medicaid or other available coverage. In order to assure the funds for uncompensated care are not abused and will be available for those in need within the NGHS service area. Northeast Georgia Physicians Group will make reasonable attempts to assist eligible candidates to become covered under any available assistance programs in the community. NGPG proactively makes reasonable efforts to determine whether a patient is eligible for financial assistance before engaging in any collection activities. DEFINITIONS Family Unit Size is defined as the applicant (patient, if applicable), spouse, and all legal dependents as allowed by the Internal Revenue Service. If patient/applicant is a minor, the family unit will include parent(s)/legal guardian(s) and any other taxpayer that can claim the patient/applicant as a dependant for income tax paying purposes. Family Unit Income is defined as gross income for all members of the family unit for the last three months or the last calendar year, whichever is the lesser amount. Examples of income are: retirement, veteran s administration, workers compensation, sick leave, disability compensation, welfare, social security retirement, alimony, child support, stock/certificate dividends, interest, or income from property. Medically Indigent is defined as an uninsured person who is not eligible for other health insurance coverage such as Medicare, Medicaid, or other private insurance. Those that are medically indigent make too much to qualify for Medicaid but too little to purchase health insurance or health care. Uninsured patients are defined as patients without third party insurance coverage for health services. Presumptive Eligibility is defined as approved financial assistance based upon a patient s indigent status, determined using criteria-based methods, such as propensity to pay scoring, evidence of 1 of 6
2 participation in low income government assistance programs, such as state funded prescription programs, Women, Infants and Children program (WIC), Supplemental Nutrition Assistance Program (SNAP, formerly food stamps), free school lunch program or other state or local assistance programs. Emergency Care is defined as care provided for an emergency medical condition. Emergency Medical Condition means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances and/or symptoms of substance abuse) such that the absence of immediate medical attention could reasonably be expected to result in either: a. placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; or b. serious impairment to bodily functions; or c. serious dysfunction of any bodily organ or part. With respect to a pregnant woman who is having contractions: a. that there is inadequate time to effect a safe transfer to another hospital before delivery; or b. that transfer may pose a threat to the health or safety of the woman or her unborn child. Medically Necessary Care is defined as care based upon generally accepted medical practices in light of conditions at the time of treatment which is appropriate and consistent with the diagnosis and the omission of which could adversely affect or fail to improve the patient s condition. It is care that is not cosmetic, experimental or deemed to be non reimbursable by traditional insurance carriers and governmental payers. It is care that is deemed medically necessary by an examining physician s determination. PROCEDURE / GUIDELINES GOVERNANCE The Financial Assistance Policy is administrated by the Revenue Cycle Division with authority and approval from the Northeast Georgia Physicians Group Board. PUBLIC RELATIONS Northeast Georgia Physicians Group will make concerted efforts to promote the Financial Assistance Program. The program is promoted through a plain language summary offered directly to all patients upon check-out, provided on the Northeast Georgia Health System web site and through the conspicuous display of signs in each clinic. In addition, the plain language summary is provided on a periodic basis to human service agencies and other community organizations. The plain language summary includes a brief description of eligibility requirements, brief summary of how to apply, website and physical location where an application and copy of the Financial Assistance Policy may be obtained, how to get an application by mail and contact and assistance information. NGPG shall make the Financial Assistance Policy, the plain language summary and the financial assistance application available in English and in the primary language of any populations with limited 2 of 6
3 proficiency in English that constitute a minimum of 5% or 1000 persons, whichever is less, of the residents of the community served. EXCLUSION Charity/Indigent Care is not provided at NGPG Urgent Care Centers. Patients presenting for care at any NGPG Urgent Care Center will be referred to the Primary Care Clinic at the County Health Department and the Good News at Noon Clinic, as appropriate, for charity/indigent urgent care needs. APPLICATION PROCESS 1. All patients desiring consideration under the Northeast Georgia Physicians Group Financial Assistance Program must complete an application, disclosing financial information that is considered pertinent to the determination of the patient's eligibility for financial assistance. Financial Assistance applications can be completed in writing, by speaking to a Financial Navigator, a phone screen or Presumptive eligibility. The patient will authorize NGPG to make inquiries of employers, banks, credit bureaus, and other institutions for the purpose of verifying statements made by the patient in applying for assistance. The application may be obtained by calling or by visiting any Financial Navigator or by printing online at When returned, the application shall be accompanied by one or more of the following types of documentation as needed for purposes of verifying income: a. A. Proof of household income must be at least one of the following: 1) A copy of four most recent pay stubs of all employed in the household. If no pay stub available, please provide a notarized letter from employer. 2) Current year W-2 and/or recent year tax return 3) Social Security Award Letter 4) Proof of workers compensation, sick leave, disability compensation, welfare, or social security retirement 5) If you have no income at this time, provide a signed and notarized letter from the person who provides food, shelter, clothing, etc. for you and your family, if applicable. b. Proof of assets 1) Most recent bank statements for personal and business checking and savings accounts c. Proof of home address must be at least one of the following: 1) Valid Georgia driver s license 2) Georgia identification card 3) Current utility bill 4) Lease or rent receipts showing evidence of county of residence 5) County property tax assessment, 6) County food stamp letter 7) Voter registration card d. These documents, if applicable: 1) If you are not married but there are children in common, you must provide entire household income. Any child support or alimony received must also be included. 2) If you are still legally married but separated, you must provide legal documentation of separation or spouse s income. 3) Written verification from public welfare agencies or other government agencies which can attest to the Patient s Gross Income status for past 12 months 4) Verification of Pension or Retirement Income 5) Verification of student status which is defined as a copy of current class schedule, registration information and a copy of student photo ID 3 of 6
4 6) If you lost your job within the last three months, you are required to provide a separation letter from your past employer. Additionally, you must provide a letter from your local Georgia Department of Labor Career Center specifying whether or not you are receiving unemployment benefits. 7) If you have listed any children on your application other than biological or stepchildren, you must provide legal documentation to this effect. 8) Patients seeking assistance due to medical indigency may need to submit evidence of assets 2. Income shall be annualized, when appropriate, based upon documentation and verbal information provided by the patient. This process will take into consideration seasonal employment and temporary increases and/or decreases of income. 3. All applications, supporting documentation, and communications will be treated with proper regard for patient confidentiality. NGPG will exercise reasonable care to maintain with the application form copies of documents that support the application. 4. In situations where the information provided by the patient or guarantor does not match the Criteria Based Method, the Criteria Based information will be considered in the eligibility determination. 5. Additional information may be requested to complete the application. ELIGIBILITY CRITERIA: 1. In cases where patients request scheduled services, applications for Financial Assistance can be processed prior to services. 2. Financial Assistance is secondary to all other financial resources available to the patient. 3. Determination of eligibility of a patient for financial assistance shall be applied regardless of the source of referral and without discrimination as to race, gender, ethnicity, color, creed, national origin, age, handicap status, or marital status. 4. Financial assistance will be provided to patients when net available assets are not sufficient and gross family income is between 0 and 300 percent of the Federal Poverty Guidelines adjusted for family size. 5. The financial obligations that remain once the financial assistance payment has been applied may be paid in a lump sum or the patient may set up a payment plan. ELIGIBILITY DETERMINATION 6. Eligibility can be determined once a completed application has been received along with ALL supporting documentation or through other criteria-based methods. Should documentation not be supplied or should the application remain incomplete, financial assistance will NOT be granted. A notification will be sent informing of how to obtain assistance to complete the application. 7. Accounts with incomplete application or no application will be subject to the normal account flow process of self pay collection statements and outsourcing to bad debt collection agencies as well as debt collection attorneys, as appropriate (See Collections Policy). 8. For medically necessary care, other than emergency care, patient should be a resident within the NGHS service area. Cases for consideration may be requested by the patient, the patient s family, the patient's physician, NGPG personnel who have been made aware of the financial need of the patient, or recognized social agencies. 4. NGPG presumptively approves patients for 100% adjustment only, using the Presumptive Eligibility criteria defined above. 4 of 6
5 5. In instances where eligibility has been determined through the use of other criteria-based methods, documentation of income and expenses may not be required. 6. Following the initial request for financial assistance, the group will pursue other sources of funding, including Medicaid and/or state programs. If a patient refuses to pursue any other source of funding, the patient will be ineligible for the Financial Assistance Program. All outstanding accounts will be notated as uncooperative and will be subject to the normal account flow process of self pay collection statements and outsourcing to bad debt collection agencies as well as debt collection attorneys if appropriate (see Collections Policy). 7. Forms and instructions will be furnished to the responsible party when financial assistance is requested, when need is indicated, or when financial screening indicates potential needs. Refusal to complete the forms will result in denial of financial assistance and will subject the account to the normal escalation process including self pay collection statements and outsourcing to bad debt collection agencies as well as debt collection attorneys (see Collections Policy). 8. The responsible party will be given fifteen (15) business days or a reasonable time as required by the person's medical condition to complete the required forms and furnish proof of income and assets. 9. Financial assistance eligibility, while generally determined at the time of application, may occur at any time prior to judgment upon learning of facts that would indicate financial need. If a responsible party pays a portion or all of the charges related to medical care and is subsequently found to have met the financial assistance care criteria at the time of application, the amount that will be eligible will be the balance due on the patient s account at the time of reapplication. 10. Approval for financial assistance is granted for periods of three (3) months. Medicare patients approval is granted for periods of twelve (12) months. If the patient/responsible party s financial situation changes after financial assistance has been approved and awarded, NGPG reserves the right to terminate future financial assistance at the discretion of the Manager of Patient Receivables in accordance with the Revenue Cycle Vice President. Examples include, but are not limited to, payouts from court settlement, lottery, etc. CALCULATION The calculation of the discount for patients qualified for a financial assistance adjustment will be based on our established discount rate of between 5%- 100% Uninsured patients (i.e. those patients without third party coverage for health care services) qualify for a financial assistance adjustment on a sliding scale as follows: Family income of 150% or less than the Federal Poverty Guidelines qualifies for a 100% financial assistance adjustment, which means that their services are free. A family income between 151%-185%of the Federal Poverty Guidelines qualifies for an adjustment based on the established discount rate of 60%. A family income between 186%-235% of the Federal Poverty Guidelines qualifies for an adjustment based on the established discount rate of 60%-10%. A family income between 236%-300% of the Federal Poverty Guidelines qualifies for an adjustment based on the established discount rate of 10%-5%. Example of the calculation: if a patient s gross charges for services are $100 the charges will be discounted to the established discount rate ($100*60%=$40.00). The patient with an income of 151%-185% of the Federal Poverty Guidelines would be responsible for $ of 6
6 Uninsured patients with family incomes greater than 300% of the Federal Poverty Guidelines may qualify for a 25% prompt pay discount (not financial assistance) when payment for services is provided before or at the time of service. NOTIFICATION 9. NGPG will make reasonable efforts to notify the patient of the final determination within thirty (30) working days of receipt of application with related documented materials (proof of income, etc.). The notification will include a determination of the amount for which the responsible party will be financially responsible, if anything, and describes how the individual may obtain information regarding how their amount owed was determined. Denials will be communicated in writing and will include instructions for appeal. 10. Financial agreement forms will state that financial responsibility is waived or reduced if the patient is determined eligible for financial assistance. APPEALS PROCESS The responsible party may request reconsideration of eligibility for financial assistance by providing additional verification of income or family size to the Patient Receivables Center Manager within 30 calendar days of receipt of notification. The Patient Receivables Center Manager will review all requests for reconsideration and will make the final determination. If the determination affirms the previous denial of financial assistance, written notification will be sent to the patient/guarantor. If the final determination is to approve financial assistance, an approval notification will be sent to the patient indicating amount waived or reduced. NON-PAYMENT PROCESS In the event of non-payment by a patient for their portion of their account balance after financial assistance is processed, the account will follow normal collection process flow (see Collections Policy). NGHS Service Area by Zip Code 30011,30019,30028,30040,30041,30501,30502,30503,30504,30506,30507,30510,30511,30512,30514, 30515,30517,30518,30519,30523,30525,30527,30528,30529,30530,30531,30533,30534,30535,30537, 30538,30542,30543,30545,30546,30547,30548,30549,30552,30554,30557,30558,30562,30563,30564, 30565,30566,30567,30568,30571,30572,30573,30575,30576,30577,30580,30581,30582,30597,30598, 30599,30620,30666, of 6
Board NGHS Board X NGMC Barrow Board THC Board NGMC Barrow Medical Staff. Health Partners Board
Title Financial Assistance, NGMC Primary Reviewer System Director, Patient Receivables Reviewer(s) VP, Revenue Cycle and Chief Financial Officer 1. Applicability- Select all Entities that are covered by
More informationUnion General Hospital. An Equal Opportunity Employer
Original Date: 02/19/2013 Title: Financial Assistance Policy Department: Patient Financial Services Union General Hospital An Equal Opportunity Employer Date Reviewed: 06/03/2015 Date Revised: 01/19/2016
More informationPrinted copies are for reference only. Please refer to the electronic copy for the latest version.
Title: Financial Assistance Policy Effective Date: 02/04/2015 Document Owner: Lori Buxton Approver(s): Helen Whitehead, Kevin Kelbly, Leslie Simmons, Sharon Sanders Printed copies are for reference only.
More information04/04 06/05, 05/10, 12/10, 03/11, 11/11, 03/12, 10/13, 09/14, 08/15, 09/17, 12/17, 09/18, 11/18
NMHS CORPORATE POLICIES AND PROCEDURES SUBJECT: FINANCIAL ASSISTANCE APPLICABLE: EFFECTIVE DATE: REVIEWED/REVISED: PURPOSE: Nebraska Methodist Hospital, Methodist Fremont Health, Methodist Jennie Edmundson,
More informationFrisbie Memorial Hospital s Financial Assistance Policy
I. PURPOSE: To set forth the procedure by which a patient may apply for financial assistance for medically necessary and emergency care provided by Frisbie Memorial Hospital and its employed providers.
More informationPOLICY #WRMS-1.02 FINANCIAL ASSISTANCE AND COLLECTION POLICY
WRMS POLICIES Administrative POLICY #WRMS-1.02 FINANCIAL ASSISTANCE AND COLLECTION POLICY SCOPE Washington Regional Medical Center ( WRMC ) PURPOSE WRMC is committed to improving the health of people in
More informationFinancial Assistance - Enterprise APPROVED BY: SENIOR VICE PRESIDENT, FINANCE, HEALTH SERVICES FORMULATED BY: SENIOR DIRECTOR, PATIENT ACCOUNTS
Sanford Health Policy ENTERPRISE Patient Financial Services: DATE REVIEWED/REVISED: 05/19/2017 Financial Assistance - Enterprise APPROVED BY: SENIOR VICE PRESIDENT, FINANCE, HEALTH SERVICES FORMULATED
More informationGRANDE RONDE HOSPITAL Version #: 5 Department: Board of Trustees Title: Financial Assistance Page 1 of 8
Page 1 of 8 Document Owner: Bob Seymour (Sr. Director of Finance/CFO) Date Created: 02/17/2010 Approver(s): Wendy Roberts (Senior Director Administrative Services) Date Approved: 11/16/2016 Printed copies
More informationFINANCIAL ASSISTANCE BILLING AND COLLECTIONS POLICY
FINANCIAL ASSISTANCE BILLING AND COLLECTIONS POLICY University Medical Center is a member of Louisiana Children s Medical Center (LCMC) Health System and is a hospital organization recognized as tax exempt
More informationMEMORIAL HERMANN HEALTH SYSTEM POLICY
Page 1 of 17 MEMORIAL HERMANN HEALTH SYSTEM POLICY POLICY TITLE: Financial Assistance Policy PUBLICATION DATE: 12/19/2017 VERSION: 4 POLICY PURPOSE: Memorial Hermann Health System ( MHHS ) operates Internal
More informationPatient Credit and Collections Policy. Penn State Health Revenue Cycle
Patient Credit and Collections Policy Penn State Health Revenue Cycle Effective Date: RC-002 5/11/2017 PURPOSE To provide clear and consistent guidelines for conducting billing, collections, and recovery
More informationPolicy Number: Approval Date: March 2018 Page 1 of 7
Page 1 of 7 TITLE: PURPOSE: POLICY: Financial Assistance Program To ensure that UF Health Jacksonville meets its community obligations to provide financial assistance in a fair, consistent and objective
More informationMEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD POLICY. Financial Assistance Policy
Page 1 of 15 MEMORIAL HERMANN SURGICAL HOSPITAL KINGWOOD POLICY POLICY TITLE: Financial Assistance Policy PUBLICATION DATE: 02/11/2019 VERSION: 3 POLICY PURPOSE: The purpose of this Financial Assistance
More informationFINANCIAL ASSISTANCE POLICY
FINANCIAL ASSISTANCE POLICY I. PURPOSE/OBJECTIVE The mission at DeKalb Medical is to deliver high quality healthcare services that improve the health and well-being of the patients served by DeKalb Medical.
More informationII. Policy Scope For purposes of this policy, "financial assistance" requests pertain to the provision of healthcare services by NLH.
I. Purpose of Policy To establish a policy for the administration of New London Hospital s (NLH) financial assistance for healthcare services program. This policy outlines the: eligibility criteria for
More informationValley Regional Hospital Patient Accounting
Valley Regional Hospital Patient Accounting Policy Date Issued 11/27/2007 Policy Date Reviewed 2/08, 2/10, 2/14, 2/17 Policy Date Revised 02/09, 2/11, 3/12, 3/13, 4/14, 2/15, 3/16, 9/16, 3/18 Policy: Financial
More informationKITTSON MEMORIAL HEALTHCARE CENTER
KITTSON MEMORIAL HEALTHCARE CENTER SUBJECT: Community Care Program REFERENCE: DEPARTMENT: Business Office PAGE 1 OF 5 POLICY OWNER: Kim Klegstad EFFECTIVE: 10-01-2016 APPROVED BY: Governing Board REVISED:
More informationCOLUMBIA ST. MARY S, Inc. FINANCIAL ASSISTANCE POLICY January 22, 2018
COLUMBIA ST. MARY S, Inc. FINANCIAL ASSISTANCE POLICY January 22, 2018 POLICY/PRINCIPLES It is the policy of, Inc. Hospital Milwaukee, St. Mary s Hospital Ozaukee, Sacred Heart Rehabilitation Institute
More informationDefinitions: As used in this Policy, the following terms have the meanings as set forth below:
Al IN" Nit, 4, Nun, NavicentHealth Patient Information for Financial Assistance The Financial Assistance Policy (FAP) of Navicent Health illustrates our commitment to our patients and the community we
More informationFinancial Assistance Program and Collection Policy
Financial Assistance Program and Collection Policy GREAT PLAINS OF SMITH COUNTY, INC. /dba Smith County Memorial Hospital Date of Board Approval: 11-28-17 Purpose: To provide financial assistance for emergency
More informationCHARLESTON AREA MEDICAL CENTER, INC. Policy No. FINANCIAL ASSISTANCE & EMERGENCY MEDICAL CARE POLICY
CHARLESTON AREA MEDICAL CENTER, INC. Policy No. FINANCIAL ASSISTANCE & EMERGENCY MEDICAL CARE POLICY GEN1200.00 Revised: April 6, 2017 Subject: Financial Assistance, Uninsured and Uncompensated Care Policy
More informationPOLICY FINANCIAL ASSISTANCE FOR THE UNINSURED & UNDERINSURED PURPOSE MGH&FC POLICY
PURPOSE Mason General Hospital & Family of Clinics (the District ) is committed to the provision of emergency health care services to all persons in need of medical attention regardless of ability to pay.
More informationMERITUS MEDICAL CENTER
DEPARTMENT: POLICY NAME: POLICY NUMBER: 0436 ORIGINATOR: EFFECTIVE DATE: 8/97 Financial Assistance REVISION DATE(s): 03/99, 03/00, 03/03, 02/04, 03/04, 06/04, 10/04, 6/05, 3/06, 2/07, 3/07, 1/08, 3/09,
More informationSCOPE: PURPOSE: Policy: HOSPITAL-WIDE
SCOPE: HOSPITAL-WIDE PURPOSE: Consistent with its mission to provide high quality health and wellness services for the community, Uvalde Memorial Hospital is committed to providing financial assistance
More informationFinancial Assistance Policy (FAP)
Financial Assistance Policy (FAP) Community United Methodist Hospital Inc. is a nonprofit, faith based, and tax-exempt healthcare system. Our mission is to provide high-quality, cost-effective healthcare
More informationNotification of this Policy to our Patients and Community members
Title: Financial Assistance Policy Dept: Revenue Cycle Effective Date: 10/1/2018 Author: Serina Blackwell Approving Authority: Kendall Johnson Review Dates: PURPOSE: To define Financial Assistance guidelines
More informationFINANCIAL ASSISTANCE POLICY SUMMARY
Reviewed: 02/09, 9/19/13, 7/17 Authority: EC Revised: 10/09, 06/15/10, 3/2/11, 10/02/13, 2/1/16, 11/17 Page: 1 of 14 FINANCIAL ASSISTANCE POLICY SUMMARY SCOPE: This policy applies to the following Adventist
More informationDefinitions: As used in this Policy, the following terms have the meanings as set forth below:
Patient Information for Financial Assistance The Financial Assistance Policy (FAP) of the Medical Center Navicent Health (NAVICENT HEALTH) illustrates our commitment to our patients and the community we
More informationFinancial Assistance Policy
NorthShore University HealthSystem Area Affected: Organization Wide Administrative Directives Manual Financial Assistance Policy 1. POLICY: The fundamental purpose of NorthShore University HealthSystem
More informationPolicy Name and Number. MCP 750.3, Charity Care. Effective Date August 8, 2017 Original Approved Date. January 13, Revised Date(s) July 5, 2017
Policy Name and Number Effective Date August 8, 2017 Original Approved Date January 13, 2015 Revised Date(s) July 5, 2017 ABSTRACT: UC San Diego Health (UCSDH) strives to provide quality patient care and
More informationFinancial Assistance Policy. REVISED DATE: August 31, 2017
FUNCTIONAL AREA: DEPARTMENT: SUBJECT: Revenue Cycle Patient Accounts Financial Assistance Policy REVISED DATE: August 31, 2017 ISSUED BY: UAP Clinic, LLC PURPOSE: To meet the needs of the communities it
More informationCOMMUNITY MEMORIAL HOSPITAL INC. BUSINESS OFFICE POLICIES AND PROCEDURES
Document Title: Financial Assistance Policy Created: January 2016 Revised: I. Purpose: To establish policies and procedures necessary to ensure that patients of Community Memorial Hospital, who for economic
More informationMERITUS MEDICAL CENTER
DEPARTMENT: POLICY NAME: POLICY NUMBER: 0436 ORIGINATOR: EFFECTIVE DATE: 8/97 Financial Assistance REVISION DATE(s): 03/99, 03/00, 03/03, 02/04, 03/04, 06/04, 10/04, 6/05, 3/06, 2/07, 3/07, 1/08, 3/09,
More informationSan Juan Regional Medical Center Financial Assistance Policy
San Juan Regional Medical Center Financial Assistance Policy 1.0 Policy: San Juan Regional Medical Center s (SJRMC) mission is to personalize healthcare and to create enthusiasm and vitality in healing.
More informationDAYTON CHILDREN S HOSPITAL FINANCIAL ASSISTANCE POLICY
DAYTON CHILDREN S HOSPITAL FINANCIAL ASSISTANCE POLICY POLICY: Dayton Children s Hospital s (DCH) Financial Assistance Policy is consistent with DCH s mission and values and is reflective of the organization
More informationFinancial Assistance Policy Effective: January 1, Policy Guidelines
Financial Assistance Policy Effective: January 1, 2016 As a specialty provider treating patients with disorders of the brain, Kennedy Krieger Institute (KKI) recognizes the unique financial stress faced
More informationWise Health System and Wise Health Clinics, Revenue Cycle
Title: Department/Service Line: Location: Document Location ID: Financial Assistance Wise Health System and Wise Health Clinics, Revenue Cycle WHS.SYS.PCP Origination Date: 5/2017 Last Review Date: 6/2017
More informationAdministrative (Non-Clinical) Policy
Administrative (Non-Clinical) Policy This administrative policy applies to the operations and staff of the University of Wisconsin Hospitals and Clinics Authority (UWHCA) as integrated effective July 1,
More informationCook Children s Northeast Hospital Financial assistance policy
Cook Children s Northeast Hospital Financial assistance policy PURPOSE To describe how Cook Children's Health Care System (CCHCS) will allocate resources for emergency and other medical care provided at
More informationSOUTH COUNTY HEALTH PATIENT ACCESS POLICIES AND PROCEDURES-
SOUTH COUNTY HEALTH PATIENT ACCESS POLICIES AND PROCEDURES- Policy No: CC 1.0 Policy Title Financial Assistance Program (Charity Care) Purpose South County Health s Financial Assistance Program is the
More informationFINANCIAL ASSISTANCE BILLING AND COLLECTIONS POLICY
FINANCIAL ASSISTANCE BILLING AND COLLECTIONS POLICY University Medical Center New Orleans is a member of Louisiana Children s Medical Center (LCMC) Health System and is a hospital organization recognized
More informationOriginal Date. Policy & Procedure Manual Written/Reviewed By: VP, Chief Financial Officer. Date: Date:
Policy: Charity Care-Financial Assistance Policy Policy & Procedure Manual Written/Reviewed By: VP, Chief Financial Officer Approved By: Norman Regional Hospital Authority Date: 5/8/2017 Date: 5/8/2017
More informationSubject: Financial Assistance Distribution: Thomas Health System
POLICY AND PROCEDURE Function: Leadership Policy Number: THS 146 Subject: Financial Assistance Distribution: Thomas Health System Prepared By: Finance Department; Legal Department; Corporate Compliance
More informationFinancial Assistance Policy
Financial Assistance Policy Policy Owner: Patient Accounts POLICY STATEMENT To establish a systematic process for the provision and determination of indigent and charity care services commensurate with
More informationMoffitt Cancer. Policy: Charity Care/Financial Assistance. Policy Statement. Purpose. Scope. Procedures. Effective: 04/2018 Page 1 of 10
Responsible Office: Business Office Category: Finance Authorized: Vice President, Revenue Cycle Policy Number: ADM-C032 Management Review Frequency: 3 years Effective: 04/2018 Policy Statement This Policy
More informationFinancial Assistance Program (Charity Care)
Financial Assistance Program (Charity Care) PURPOSE: To establish a policy and procedure for the administration of Northeastern Vermont Regional Hospital s Financial Assistance Program. POLICY STATEMENT:
More informationMEMORIAL HERMANN HEALTH SYSTEM POLICY
Page 1 of 17 MEMORIAL HERMANN HEALTH SYSTEM POLICY POLICY TITLE: Financial Assistance Policy ("FAP") PUBLICATION DATE: 05/10/2016 VERSION: 3 POLICY PURPOSE: The purpose of this Financial Assistance Policy
More informationDocument Type. 1. Money, wages, and salaries before any deduction, but not including food or rent in lieu of wages.
Document Title Owner Applicable Department(s) KIRBY FINANCIAL ASSISTANCE PROGRAM DIRECTOR OF PATIENT FINANCIAL SERVICES PATIENT FINANCIAL SERVICES, PATIENT REGISTRATION Document Type POLICY Reviewed 3/14,
More informationSCOPE: Business Office Page 1 of 11
PARK PLACE SURGICAL HOSPITAL SUBJECT: Hardship Discount Cases POLICY NUMBER: BO.102 POLICIES AND PROCEDURES DEPARTMENT: Business Office EFFECTIVE DATE: 06/03 REVISION DATE: 08/10, 06/16, ORIGIN DATE: 06/03
More informationFinance Division Revenue Cycle Operational Policy Page 1 of 6. Financial Assistance Program
Finance Division Revenue Cycle Operational Policy Page 1 of 6 Financial Assistance Program I. POLICY STATEMENT Origination Date: Revision Date: 2/4/09 4/15/09, 8/3/09, 2/15/11, 3/14, 1/16, 11/16 Grady
More informationADMINISTRATIVE/OPERATIONS POLICY FINANCIAL ASSISTANCE POLICY
ADMINISTRATIVE/OPERATIONS POLICY FINANCIAL ASSISTANCE POLICY Effective Date: September 1, 2017 Approval: Southwest Post-Acute Care Partnership, LLC Board of Managers SCOPE: The provisions of this policy
More informationSOUTHERN COOS HOSPITAL AND HEALTH CENTER 09/20/ /15/ /15/2017 MM/DD/YYYY. Annually. JoDee TIttle JoDee TIttle (Dec 17, 2017)
Title: Key Words: Affected Departments: Patient Financial Services Responsible Authority: Patient Financial Services Effective Date: Revision Date: Reviewed Date: Obsoleted Date: 09/20/2017 09/15/2017
More informationADMINISTRATIVE POLICY COMPASSIONATE CARE
ADMINISTRATIVE POLICY COMPASSIONATE CARE I. Purpose Statement McLeod Health is committed to providing hospital-sponsored charity care (herein referred to as "Compassionate Care") to persons who have healthcare
More informationADVENTIST MIDWEST HEALTH REGIONAL POLICY PROFILE Category. Adventist Midwest Health Financial Assistance Policy
Page 1 of 16 I. PURPOSE The describes the Financial Assistance practices of Adventist Midwest Health. Adventist Midwest Health ( AMH ) includes five hospitals in Adventist Health System s Midwest Region:
More informationThe Johns Hopkins Health System Policy & Procedure FINANCIAL ASSISTANCE
Page 1 of 19 POLICY This policy applies to The Johns Hopkins Health System Corporation (JHHS) following entities: The Johns Hopkins Hospital (JHH), Johns Hopkins Bayview Medical Center, Inc. Acute Care
More informationFinancial Assistance Program (FAP): Known in this policy as Financial Care.
POLICY POLICY TITLE: POLICY: SCOPE: Financial Care St. Luke s Health System is committed to caring for the health and well-being of all patients regardless of their ability to pay for all or part of the
More informationPOLICY: FINANCIAL ASSISTANCE, BILLING AND COLLECTIONS
SUBJECT: Financial Assistance, Billing and Collections ORIGINATED BY: Finance Department APPROVED BY: Administrative Staff LEGAL REVIEW: POLICY NO: DATE OF ORIGIN: 12/29/15 REVIEW DATES: 11/18/15 LATEST
More informationTitle: Financial Assistance Policy. Policy Procedure Guideline Other: Scope: System. Advocate Health Care I. PURPOSE
Title: Financial Assistance Policy Policy Procedure Guideline Other: Advocate Health Care I. PURPOSE Scope: System Site: Department: A. The fundamental purpose of Advocate Health Care (AHC) is to provide
More informationAdministrative Policy. Title: Financial Assistance, Billing and Collection
St. Joseph s / Candler Health System, Inc. Administrative Policy Title: Financial Assistance, Billing and Collection Policy Number: 1220-A Effective Date: 02/20/2018 Page 1 of 11 Policy Statement It shall
More informationNORTHEAST MONTANA HEALTH SERVICES, INC. d.b.a. Poplar Community Hospital and Wolf Point Hospital
NORTHEAST MONTANA HEALTH SERVICES, INC. d.b.a. Poplar Community Hospital and Wolf Point Hospital PATIENT ACCOUNTING FINANCIAL ASSISTANCE POLICY (CHARITY CARE) Policy Approval Date: September 27 th 2018
More informationHospital-Wide Policy Manual Section Leadership Page 1 of 6
Unique Identifier: HWP12027 TITLE: Financial Assistance Policy DAY KIMBALL HEALTHCARE Page 1 of 6 RESPONSIBLE PARTY (IES): Director of Revenue Cycle Vice President and CFO FORMERLY KNOWN AS: Charity Free
More informationIncluded: Screening and/or wellness services that fall within the recommendations of the American Cancer Society Guidelines.
Memorial Hospital Carthage, Illinois POLICY TITLE: Financial Assistance Policy RECOMMENDED BY: Patient Access and Patient Accounts SUPERSEDES: Uncompensated Services CONCURRENCE(S): Memorial Medical Clinics
More informationCurrent Status: Active PolicyStat ID: Charity and Financial Assistance Policy
Current Status: Active PolicyStat ID: 4995973 Original Issue: 01/2004 Approved: 05/2018 Last Revised: 05/2018 Author: Pamela Hull: Administrative Assistant Department: Administration References: Policy:
More informationMURPHY MEDICAL CENTER, INC.
MURPHY MEDICAL CENTER, INC. DEPARTMENT: Business Office/Patient Accounts SUBJECT: Financial Assistance Policy RELATED TO: JCAHO: NCR&R OSHA: ISSUE DATE: 09-97 REVISED: 03-2009; 03-2011; 02-2014; 02-2016
More informationKIT CARSON COUNTY HEALTH SERVICE DISTRICT TH Street, Burlington, CO 80807
Department: District Wide Original Date: 01/01/2013 Review Dates: Effective Date: 01/01/2013 Revision Dates: 12/23/2015 Department Approval: Administrative Approval: Board of Directors Page 1 of 8 Title:
More informationEASTERN CONNECTICUT HEALTH NETWORK POLICY AND PROCEDURE
TITLE: Financial Assistance Policy and Procedure Policy: 500 TOPIC Financial Assistance / Charity Care ECHN is committed to providing financial assistance to persons who have healthcare needs and are uninsured,
More informationLIBERTY HOSPITAL Liberty, Missouri
Page 1 of 15 GUIDELINE: New Liberty Hospital District Financial Assistance Policy DEPARTMENT: Hospital Wide EFFECTIVE DATE: July 1, 2016 REPLACES: NEW PURPOSE: Liberty Hospital is the name commonly used
More informationBUS - Collection Policy
STATEMENT OF POLICY: Peterson Regional Medical Center (PRMC) is the frontline caregiver providing medically necessary care for all people regardless of ability to pay. PRMC offers this care for all patients
More informationFINANCIAL ASSISTANCE. To provide financial assistance counseling to DotHouse Health patients
Page: 1 Policy #: 8.19 Issued: November 2016 Reviewed/Revised: Section: Finance FINANCIAL ASSISTANCE Purpose: To provide financial assistance counseling to DotHouse Health patients Policy Statement: The
More informationFinancial Assistance & Discount Policy for Uninsured or Underinsured, POLICY:
Effective: 07/2003 Last Reviewed: 07/2017 Last Revised: 07/2017 Next Review: 02/2020 Owner: Section/Dept: References: Applicability: Pam Hess, CFO Finance St. Vincent s HealthCare Financial Assistance
More informationPOLICY TITLE: FINANCIAL ASSISTANCE Former Policy Title:
POLICY TITLE: FINANCIAL ASSISTANCE Former Policy Title: Issued By: Mission and Community Benefit Board Approved on July 10, 2018 Next Review Scheduled for June 30, 2019 POLICY PURPOSE It is the purpose
More informationUniversity of Pennsylvania Health System Health Services Policy and Procedure. Effective: Page: 1 of 11
Page: 1 of 11 Keywords Free Care Uninsured Under insured Financial counseling Financial assistance Charity Care See Also HUP #1-12-17 Non-Discrimination PPMC #02.100 Non-Discrimination PAH #CC1 Admission
More informationChapter 5. Eligibility Determination Process. This chapter covers the eligibility process pertaining to HCRA. It covers the following in detail:
Chapter 5 Eligibility Determination Process This chapter covers the eligibility process pertaining to HCRA. It covers the following in detail: A. The documents that are to be provided and used to verify
More informationCALVERT HEALTH SYSTEM PRINCE FREDERICK, MARYLAND 20678
CALVERT HEALTH SYSTEM PRINCE FREDERICK, MARYLAND 20678 Policy Name: Financial Assistance Policy Number: BD9 Category: Clinical Non- Clinical Review Responsibility: Director, Patient Financial Services
More informationTITLE: HOSPITAL FINANCIAL ASSISTANCE POLICY
TITLE: HOSPITAL FINANCIAL ASSISTANCE POLICY X ADMINISTRATIVE CLINICAL EFFECTIVE DATE: 05/15/2017* APPROVED BY: Premier Health Board X APPROVED DATE: 4/25/2017 *Previous effective dates of 5/22/1992,1/1/2011,
More informationARIA HEALTH SYSTEMS ADMINISTRATIVE POLICY
ARIA HEALTH SYSTEMS ADMINISTRATIVE POLICY SUBJECT: Charity Care and Financial Assistance DATE: April 2013 Purpose Consistent with its Mission and Values, Aria Health considers each individual s ability
More informationLEGACY HEALTH SYSTEM. Next Revision Date: 01/2016 LHS Board Approval: 01/2010
Title: 400.17 Financial Assistance Revision: 1.5 LEGACY HEALTH SYSTEM ADMINISTRATIVE Policy #: 400.17 Origination Date: 12/94 Last Revision Date: 01/2013 Next Revision Date: 01/2016 LHS Board Approval:
More informationSigns are posted throughout the facility to provide education about charity/fap policies.
Page 1 of 12 I. PURPOSE UC Irvine Medical Center strives to provide quality patient care and high standards for the communities we serve. This policy demonstrates UC Irvine Medical Center s commitment
More informationTitle Financial Assistance Policy Policy No Approved By PeaceHealth Board of Directors Page Number 1 of 9
Approved By PeaceHealth Board of Directors Page Number 1 of 9 SCOPE This policy applies to the PeaceHealth Divisions (PHDs), checked below: Cottage Grove Medical Center Peace Island Medical Center St.
More informationFinancial Assistance Policy
LCMC HEALTH - Touro Infirmary Policy: Financial Assistance, Billing and Collection Policy Policy No: 181 Revised: 04/07/2018 Supersedes Policy: Authorized By: Touro Infirmary Finance Committee of the Board
More informationPolicies and Procedures
Policies and Procedures Policy Title: Financial Assistance Program (FAP) Department Responsible: Patient Accounting Policy Code: OP-PAC-2014-204 Effective Date: June 12, 2017 Next Review/Revision Date:
More informationFinancial Assistance Policy
LCMC HEALTH - University Medical Center New Orleans Policy: Financial Assistance, Billing and Collection Policy Policy No: Revised: 2-1-2018/ 2-8-2019 Supersedes Policy: Authorized By: University Medical
More informationWillis-Knighton Health System. Financial Assistance Policy and Procedures
Willis-Knighton Health System Financial Assistance Policy and Procedures 1. Policy Willis-Knighton Health System is committed to providing financial assistance to persons who have healthcare needs and
More informationFinancial Assistance Policy
Financial Assistance Policy POLICY: Scotland Memorial Hospital shall provide appropriate levels of care, commensurate with the facility's resources and the community needs. Scotland Memorial Hospital is
More informationIngalls Hospital. Hospital Manual Section Policy FAP. Reviewed By 01/26/2015. Revised By Judith Genovese, Manager 01/26/2015
Ingalls Hospital Hospital Manual Section Policy FAP Reviewed By 01/26/2015 Revised By Judith Genovese, Manager 01/26/2015 Title Financial Assistance Program (FAP) Policy and Procedure 2015 Pages 9 A. SCOPE:
More informationFinancial Assistance (Charity Care and Discounted Care)
POLICY NUMBER: ADM 043.0 ORIGINAL DATE: 04/27/05 REVISED / REVIEWED DATE: 01/25/16 PREVIOUS NAME/NUMBER: LDR 33.0 Financial Assistance (Charity Care and Discounted Care) PURPOSE: Children s Hospital Los
More informationSUBJECT: Board Approval Date: EFFECTIVE: POLICY NUM: CONTACT: Christine Feucht, Director Patient Financial Services I. Applies to II.
SUBJECT: Billing and Collection Policy Board Approval Date: 06/02/2017 EFFECTIVE: 07/01/2017 POLICY NUM: SXKPPKZ72WEZ-3-936 CONTACT: Christine Feucht, Director Patient Financial Services I. Applies to
More informationEMH SYSTEM-WIDE HOSPITAL POLICY EMRMC AND EMFLH. Policy #: EMH SWH 044. TITLE: FINANCIAL ASSISTANCE PROGRAM APPROVAL SIGNATURES: President / C.E.O.
EMH SYSTEM-WIDE HOSPITAL POLICY EMRMC AND EMFLH Policy #: EMH SWH 044 TITLE: FINANCIAL ASSISTANCE PROGRAM APPROVAL SIGNATURES: President / C.E.O.: Origination Date: Approval Date: I. PURPOSE A. Ephraim
More informationPHILIP HEALTH SERVICES. Financial Assistance
PHILIP HEALTH SERVICES Originating Department: Patient Financial Services Affected Departments/Employees: Patient Financial Services Financial Assistance Purpose: In accordance with our Mission, Vision,
More informationPatient Financial Assistance Program
Patient Financial Assistance Program Mary Washington Healthcare Level: Supersedes: Hospitals Mary Washington Hospital, Stafford Hospital Patient Financial Assistance Program (corporate); Patient Financial
More informationCharity, Financial Assistance. Definitions The following definitions are applicable to all sections of this policy.
Title: Effective Date: 02/01/13 Distribution: Attachments: Formulated By: Keywords: Patient Business Services None Patient Business Services Charity, Financial Assistance I. Purpose: The purpose of the
More informationMEADVILLE MEDICAL CENTER HEALTH SYSTEM POLICY AND PROCEDURE MANUAL. Administrative Policy A-401
A-401 Patient Financial Assistance 1 MEADVILLE MEDICAL CENTER HEALTH SYSTEM POLICY AND PROCEDURE MANUAL Administrative Policy A-401 SUBJECT: Patient Financial Assistance PURPOSE: This policy and the Financial
More informationBilling and Collection Standard Operating Guidelines
Tuscarawas County Health Department Billing and Collection Standard Operating Guidelines Medical Clinic and Alcohol and Addiction Program Version 1.0 Effective May 11, 2018 Revision Table Date Revision
More informationSECTION: A (1) SUBJECT: FINANCIAL ASSISTANCE POLICY; COLLECTIONS ACTIVITIES
KING S DAUGHTERS MEDICAL CENTER ADMINISTRATIVE POLICY POLICY AND PROCEDURE EFFECTIVE DATE: 06/01/2017 SUPERSEDES POLICY DATED: 12/95; 3/98; 2/01; 4/04; 12/04; 7/05; 1/07; 11/11; 2/1/13; 7/10/14; 1/1/2016;
More informationCHARITY CARE DISCOUNT POLICY
CHARITY CARE DISCOUNT POLICY POLICY STATEMENT The Hospital shall contribute appropriate resources, advocacy and community support to promote the health status of the community, which it serves, within
More informationChildren s National Financial Assistance Application
Children s National Financial Assistance Application Children s National will offer financial assistance to patients who are unable to pay their hospital and/or clinic bills due to difficult financial
More informationVan Diest Medical Center Standardized Financial Assistance Application (Page 1 of 2)
Patient Information Account # Name Social Security # Date of Birth Did you file taxes last year? Yes No Patient/Guarantor (Person responsible for bill) Information Name Social Security # Date of Birth
More informationPolicy #: Title: Patient Financial Assistance Policy. Category: Effective Date: 9/1/2004. Revised Date: 4/1/2014. Reviewed Date: 1/12/2018
Policy #: 2.1.3 Title: Patient Financial Assistance Policy Category: Effective Date: 9/1/2004 Revised Date: 4/1/2014 Approved By: MidMichigan Health s Corporate Finance Committee Signed by: Diane Postler-Slattery,
More informationFALLON MEDICAL COMPLEX
Friends Healing Friends FALLON MEDICAL COMPLEX PO Box 820 202 South 4 th Street West Baker, MT 59313-0820 (406) 778-3331 FAX (406) 778-2488 www.fallonmedical.org FMC Patient Care Financial Assistance Policy
More informationMANUAL/DEPARTMENT ORIGINATION DATE DECEMBER 2015 LAST DATE OF REVIEW OR REVISION APPROVED BY
MANUAL/DEPARTMENT ADMINISTRATIVE POLICY AND PROCEDURE MANUAL ORIGINATION DATE DECEMBER 2015 LAST DATE OF REVIEW OR REVISION REVIEW: MARCH 2016 REVISION: JULY 2017, DECEMBER 2017 APPROVED BY TITLE: FINANCIAL
More information